The service emphasises the importance of individuals as part of their local community and seeks to assist them to develop community networks and relationships of their own.The service has undertaken some institutional reform work in recent years, assisting people who have been living in institutions to move into their own homes in the community.

Individuals and families can self-refer and if they have no support package they will generally be assisted to apply for support funding.

What is community living?

Community-living refers to the programs, services and other supports that enable children and adults with mental retardation and related disabilities to live much the same way that people without disabilities live. For children, this usually means living with their family in their own home and in their own communities. For adults, it usually means having opportunities and supports to live independently, or as independently as possible, in their own home or apartment, or perhaps in a small group home. Community living may also include a variety of other supports and services. For example, a family that is caring for a child with mental retardation may need occasional respite services so that they can take a break from caregiving or attend to other needs. Or, an adult living in a small group home may require help finding a job through an employment program.

What are some of the trends that affect the availability and use of community services?

There are several trends that affect the availability and use of community services. Many of these trends inter-relate in how they impact individuals with mental retardation and their families.

Perhaps the most significant trend is the increasing waiting list for community services. As states either cap or cutback the number and kinds of services, more and more individuals end up on long waiting lists for necessary services. Many individuals with mental retardation do not receive the full array of services they need to increase their independence, and there are many who still reside with their families and receive no services whatsoever.

The number of adults with mental retardation still residing with their parents, especially aging parents or parent, is another area of concern. Many parents provide some or all care for an adult son or daughter with mental retardation, but these families increasingly recognize the need to plan for the time when the parents can no longer provide care. As these families begin to explore community residential and other services, they are finding waiting lists for services, sometimes up to several years long. Compounding this problem is the fact that some of these families do not even have access to a support system for providing information and assistance. A recent study in New York found that many of these families are neither in the aging service system or the mental retardation/developmental disabilities service system.

Deinstitutionalization of people with mental retardation has been an extremely positive trend. However, this trend has also increased the need for community services to serve individuals with mental retardation and their families. Many states are not allowing funds to "follow" individuals from institutions to the community. Thus, costly institutions continue to exist while states struggle with funding quality community services.

Dramatic changes in how the service-delivery system for people with mental retardation operates is having a major impact. States are experimenting with service delivery measures -- often referred to as "managed care" -- in an effort to reduce costs for health and long-term care. While managed care and other systemic changes have the potential to reduce costs and improve the quality and quantity of services, the speed and degree at which states are changing systems may create service gaps or result in less than optimal services for some or all people with mental retardation.

What types of community services are available?

Supported living: Usually individuals living in homes or apartments of their own. The person may live alone or choose to live with a roommate versus being placed with others. Supported living often involves partnerships between individuals with disabilities, their families and professionals in making decisions about where and how the person wishes to live. Focus is on giving utmost attention to the desires of the person with a disability in how he or she would like to live, and to support the individual in having control over choices of lifestyle. People in supported living may need little or no services from professionals, or they may need 24-hour personal care. The kind and amount of supports are tailored to the individual's needs.

Small group homes: Small group homes are living environments where six or fewer individuals live, usually with 24-hour staff support. In 1996, Prouty & Lakin found that an average of 3.8 people with mental retardation and related developmental disabilities lived in each residential setting in the U.S. The average number was 22.5 people in 1977, and so has continued to drop over the past 19 years.